Functional and quality of life outcomes of localised prostate cancer treatments (Prostate Testing for Cancer and Treatment [ProtecT] study)

被引：52

作者：

Lane, Janet Athene ^{[1
,2
]}

Donovan, Jenny L. ^{[1
]}

Young, Grace J. ^{[1
,2
]}

Davis, Michael ^{[1
]}

Walsh, Eleanor, I ^{[1
]}

Avery, Kerry N. L. ^{[1
,3
]}

Blazeby, Jane M. ^{[1
,3
]}

Mason, Malcolm D. ^{[4
]}

Martin, Richard M. ^{[1
,3
]}

Peters, Tim J. ^{[1
]}

Turner, Emma L. ^{[1
]}

Wade, Julia ^{[1
]}

Bollina, Prasad ^{[5
]}

Catto, James W. F. ^{[6
]}

Doherty, Alan ^{[7
]}

Gillatt, David ^{[8
,9
]}

Gnanapragasam, Vincent ^{[10
]}

Hughes, Owen ^{[11
]}

Kockelbergh, Roger ^{[12
]}

Kynaston, Howard ^{[11
]}

Oxley, Jon ^{[13
]}

Paul, Alan ^{[14
]}

Paez, Edgar ^{[15
]}

Rosario, Derek J. ^{[6
]}

Rowe, Edward ^{[8
,9
]}

Staffurth, John ^{[16
]}

Neal, David E. ^{[17
]}

Hamdy, Freddie C. ^{[17
,18
,19
]}

Metcalfe, Chris ^{[1
]}

机构：

[1] Univ Bristol, Bristol Med Sch, Canynge Hall, Bristol BS8 2PS, Avon, England

[2] Univ Bristol, Bristol Trials Ctr, Bristol, Avon, England

[3] Univ Bristol, NIHR Bristol Biomed Res Ctr, Bristol, Avon, England

[4] Univ Edinburgh, Sch Med, Edinburgh, Midlothian, Scotland

[5] Univ Edinburgh, Western Gen Hosp, Dept Urol & Surg, Edinburgh, Midlothian, Scotland

[6] Univ Sheffield, Acad Urol Unit, Sheffield, S Yorkshire, England

[7] Queen Elizabeth Hosp, Dept Urol, Birmingham, W Midlands, England

[8] Southmead Hosp, Dept Urol, Bristol, Avon, England

[9] Bristol Urol Inst, Bristol, Avon, England

[10] Addenbrookes Hosp, Dept Urol, Cambridge, England

[11] Cardiff & Vale Univ Hlth Board, Dept Urol, Cardiff, Wales

[12] Univ Hosp Leicester, Dept Urol, Leicester, Leics, England

[13] North Bristol NHS Trust, Dept Cellular Pathol, Bristol, Avon, England

[14] Leeds Teaching Hosp NHS Trust, Dept Urol, Leeds, W Yorkshire, England

[15] Freeman Rd Hosp, Dept Urol, Newcastle Upon Tyne, Tyne & Wear, England

[16] Cardiff Univ, Sch Med, Div Canc & Genet, Cardiff, Wales

[17] Univ Oxford, Nuffield Dept Surg Sci, Oxford, England

[18] Oxford Univ Hosp NHS Fdn Trust, NIHR Oxford Biomed Res Ctr, Oxford, England

[19] Univ Oxford, Oxford, England

来源：

BJU INTERNATIONAL | 2022年 / 130卷 / 03期

关键词：

localised prostate cancer; treatments; patient-reported outcomes; functional outcomes; quality of life; #PCSM; #ProstateCancer; #uroonc; PATIENT-REPORTED OUTCOMES; RADICAL PROSTATECTOMY; ACTIVE SURVEILLANCE; FOLLOW-UP; RADIOTHERAPY; TRIAL; VALIDATION; DESIGN; BRACHYTHERAPY; URINARY;

D O I：

10.1111/bju.15739

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision-making. Patients and Methods Men aged 50-69 years diagnosed with localised prostate cancer by prostate-specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external-beam radiotherapy (EBRT) with concurrent androgen-deprivation therapy (ADT) and 77 low-dose-rate brachytherapy (BT, not a randomised treatment). Patient-reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores. Results Treatment-received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL. Conclusion Treatment decision-making for localised prostate cancer can be informed by these 6-year functional and QoL outcomes.

引用

页码：370 / 380

页数：11

共 30 条

[1] ICIQ: A brief and robust measure for evaluating the symptoms and impact of urinary incontinence [J].

Avery, K ;

Donovan, J ;

Peters, TJ ;

Shaw, C ;

Gotoh, M ;

Abrams, P .

NEUROUROLOGY AND URODYNAMICS, 2004, 23 (04) :322-330

[2]

Barocas DA, 2013, J COMP EFFECT RES, V2, P445, DOI [10.2217/cer.13.34, 10.2217/CER.13.34]

[3] How Does Active Surveillance for Prostate Cancer Affect Quality of Life? A Systematic Review [J].

Bellardita, Lara ;

Valdagni, Riccardo ;

van den Bergh, Roderick ;

Randsdorp, Hans ;

Repetto, Claudia ;

Venderbos, Lionne D. F. ;

Lane, J. Athene ;

Korfage, Ida J. .

EUROPEAN UROLOGY, 2015, 67 (04) :637-645

[4] Association Between Choice of Radical Prostatectomy, External Beam Radiotherapy, Brachytherapy, or Active Surveillance and Patient-Reported Quality of Life Among Men With Localized Prostate Cancer [J].

Chen, Ronald C. ;

Basak, Ramsankar ;

Meyer, Anne-Marie ;

Kuo, Tzy-Mey ;

Carpenter, William R. ;

Agans, Robert P. ;

Broughman, James R. ;

Reeve, Bryce B. ;

Nielsen, Matthew E. ;

Usinger, Deborah S. ;

Spearman, Kiayni C. ;

Walden, Sarah ;

Kaleel, Dianne ;

Anderson, Mary ;

Sturmer, Til ;

Godley, Paul A. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2017, 317 (11) :1141-1150

[5] Recommended Patient-Reported Core Set of Symptoms to Measure in Prostate Cancer Treatment Trials [J].

Chen, Ronald C. ;

Chang, Peter ;

Vetter, Richard J. ;

Lukka, Himansu ;

Stokes, William A. ;

Sanda, Martin G. ;

Watkins-Bruner, Deborah ;

Reeve, Bryce B. ;

Sandler, Howard M. .

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2014, 106 (07)

[6] Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer [J].

Donovan, J. L. ;

Hamdy, F. C. ;

Lane, J. A. ;

Mason, M. ;

Metcalfe, C. ;

Walsh, E. ;

Blazeby, J. M. ;

Peters, T. J. ;

Holding, P. ;

Bonnington, S. ;

Lennon, T. ;

Bradshaw, L. ;

Cooper, D. ;

Herbert, P. ;

Howson, J. ;

Jones, A. ;

Lyons, N. ;

Salter, E. ;

Thompson, P. ;

Tidball, S. ;

Blaikie, J. ;

Gray, C. ;

Bollina, P. ;

Catto, J. ;

Doble, A. ;

Doherty, A. ;

Gillatt, D. ;

Kockelbergh, R. ;

Kynaston, H. ;

Paul, A. ;

Powell, P. ;

Prescott, S. ;

Rosario, D. J. ;

Rowe, E. ;

Davis, M. ;

Turner, E. L. ;

Martin, R. M. ;

Neal, D. E. .

NEW ENGLAND JOURNAL OF MEDICINE, 2016, 375 (15) :1425-1437

[7] Factors associated with trial recruitment, preferences, and treatments received were elucidated in a comprehensive cohort study [J].

Donovan, Jenny L. ;

Opmeer, Brent ;

Young, Grace J. ;

Mills, Nicola ;

Martin, Richard M. ;

Lane, J. Athene ;

Metcalfe, Chris ;

Peters, Tim J. ;

Davis, Michael ;

Turner, Emma L. ;

Walsh, Eleanor ;

Neal, David E. ;

Hamdy, Freddie C. .

JOURNAL OF CLINICAL EPIDEMIOLOGY, 2019, 113 :200-213

[8] A prospective cohort and extended comprehensive-cohort design provided insights about the generalizability of a pragmatic trial: the ProtecT prostate cancer trial [J].

Donovan, Jenny L. ;

Young, Grace J. ;

Walsh, Eleanor I. ;

Metcalfe, Chris ;

Lane, J. Athene ;

Martin, Richard M. ;

Tazewell, Marta K. ;

Davis, Michael ;

Peters, Tim J. ;

Turner, Emma L. ;

Mills, Nicola ;

Khazragui, Hanan ;

Khera, Tarnjit K. ;

Neal, David E. ;

Hamdy, Freddie C. .

JOURNAL OF CLINICAL EPIDEMIOLOGY, 2018, 96 :35-46

[9] Scoring the short form ICSmaleSF questionnaire [J].

Donovan, JL ;

Peters, TJ ;

Abrams, P ;

Brookes, ST ;

De la Rosette, JJMCH ;

Schäfer, W .

JOURNAL OF UROLOGY, 2000, 164 (06) :1948-1955

[10] Prostate-Specific Antigen-Based Screening for Prostate Cancer Evidence Report and Systematic Review for the US Preventive Services Task Force [J].

Fenton, Joshua J. ;

Weyrich, Meghan S. ;

Durbin, Shauna ;

Liu, Yu ;

Bang, Heejung ;

Melnikow, Joy .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2018, 319 (18) :1914-1931

← 1 2 3 →